Engaging family members during early SUD treatment: A hybrid trial

About This Grant

PROJECT ABSTRACT Family members (FMs; biological, extended, or chosen family) impacted by SUD experience chronic stress that places them at high risk for mental and physical health consequences. These consequences are exacerbated by the stigma, guilt, shame and self-blame that often occur in families with an individual using substances. As a result, FMs impacted by SUD often experience social isolation and are unsure how to best support their loved one in recovery. While these FMs are motivated to support their loved one in the treatment navigation process, they seldom seek support for themselves. Programs like Community Reinforcement and Family Training (CRAFT) provide support to FMs and equip them with tools to improve their own lives while supporting their loved one. While CRAFT is well-established in community settings for increasing their loved one’s SUD treatment initiation, less is known about the applicability of CRAFT in clinical SUD settings. Thus, it remains unclear whether CRAFT can enhance patient treatment retention in these settings and whether FMs who might not otherwise seek care would participate. To advance the science of engaging and supporting families impacted by SUD, we will take a multiphase approach and: (1) conduct an iterative, online process with FMs and clinic staff to identify potential family engagement strategies that community health clinics (CHCs) can deliver that may be effective, feasible, acceptable, and appropriate (R61 Aim 1; N=100), (2) test those strategies using a fractional factorial trial (R61 Aim 2; N=100), (3) combine the most effective strategy with CRAFT and conduct an RCT to test this optimized intervention versus usual care for patient and FM dyads recruited from CHCs that provide SUD treatment (R33 Aim 3; N=200 dyads). Finally, we will conduct interviews with FMs, clinic staff, and financing experts to assess factors influencing future implementation and dissemination of FM interventions in clinical SUD settings (Aim 4; N=30-35). By prioritizing strategies to engage FMs, we aim to enhance both the effectiveness and adoption of family-focused interventions, while also advancing research on how to best optimize the involvement of this often-overlooked group.